You are the only ones left in the country that doesn’t have some sort of government paid health care, Tim.
Alicia had just made breakfast smoothies and Tim was recuperating from his latest medical bills and an increase in his insurance premium. He and I were sitting in the garden next to the pool with our neighbor, Erica, and I was about to make him more depressed.
“What do you mean?” said Tim.
Well, I don’t have health insurance, Erica is covered by Tri-care, and since you don’t have a job, you have Cobra. You pay for all of your premiums, right?
Well, if you are employed or covered under some plan, your employer or the agency that generates your plan pays most of the costs, right? I mean, you pay a premium, but most of the cost comes out of somebody else’s pocket.
That’s right. I have 18 months of Cobra, but I pay all the costs.
I turned to Erica. Rev up that search engine on your laptop.
“I knew you asked me to bring it for a reason,” said Erica. “These smoothies are never free.”
How many people are in the United States, now.
“The History Channel said 308 million last week,” said Tim.
“That’s about right,” confirmed Erica, her fingers flying. “About 310 million.”
I think Medicare covers 45 million and Medicaid covers 55 million.
Erica said, “Figure 95 million total. Some are covered by both. You don’t want to double count.” She continued, “but don’t forget about the other small programs, like State Children’s Health Insurance and Indian Health Services. They add about another 10 million.”
Ok, that brings the obviously government funded programs covering about 105 million. Got that.
“Got it,” said Tim.
Well there are 1.4 million people in the armed forces they and with their dependents and retirees come up to about 9 million and are all covered by Tri-care. That’s the government, right? They might pay premiums, but the government pays the bulk.
Then, we have the VA system. They cover another 9 million veterans.
“Aren’t you double counting,” asked Tim?
No, there are lots of veterans who are not covered by Tri-care.
“OK, so that’s 123 million so far,” said Tim. “You’re straining my brain with numbers so early in the morning.”
We’ve already gone over this, but when you have health insurance through your employer, you pay a premium but the employer pays most of the cost, right?
“Right,” said Tim.
Well, the Federal Employee Health Benefits Program covers all of the people who work for the federal government and their families. How many does that cover, Erica.
“Says here 9 million.” Erica’s search engine was smokin’.
Add in the Post Office.
“About 700,000,” said Erica.
And their families.
And the people work for local and state governments.
“Let’s see,” said Erica, “2.4 million work for the states, 5.6 million work for local governments. Not counting public schools.”
She continued surfing. “4.77 million for ‘all public school employees’ in 2008. That’s the closest I can come.”
If you include retirees and dependents, our various state and local governments must cover about 30 million people.
“That’s not federal government,” countered Tim.
I said ‘some sort of government paid health care.’ Local governments are governments, too. That comes out of our tax dollars.
So far that includes all of congress, our governor, our president and his family, and the local harbormaster and her family.
“I think she’s divorced,” said Tim.
Are you paying attention? What are we up to?
“Say 162 million, I think.” said Tim. “So all those congressmen that say we shouldn’t have Universal Health because it will cover abortions or you won’t have a choice of doctor, or the waiting time will be too long, they already have their insurance paid for by the government?”
“Anyone else?” said Tim.
How many bad guys in prison right now, Erica?
“Two and a half million.”
“Really?” asked Tim.
“Federal, state, and local,” said Erica. “Believe me, I know. I’ve got two ex-husbands in the slammer, and a daughter knocking on the door.”
“Really?” asked Tim.
Erica gave him a look.
Trying to change the subject, I said, there are various other state and federal programs that cover say, another, couple of million people and then it gets more complicated.
“How so?” said Tim.
Well, for instance, there are how many workers employed in the health care industry, Erica?
“Says here, 14 million. What’s that got to do with this?”
Their employers pay the bulk of their health premiums, but where do their employers, like our local hospital down the road, where do they get their funds?
Well, answering my own question, they get their funds primarily from insurance payments for patient’s they take care of. That’s mostly from Medicare, Medicaid, Tri-care and the rest. Get my drift? The health care system is running on government dollars already. So health care workers plus all of their insured families make up about another 30 million.
“Sounds like trickle down economics,” said Erica.
And then the uninsured, like myself. That’s about 50 million right now. If we manage to be seen in the hospital or emergency room, my bill is written off as a bad debt by the hospital. However, somebody pays for that. And where that money comes from is usually some local, state, or federal agency in a round about way. So the government is paying for that care, also.
“So that totals to what,” asked Tim.
That leaves only you still paying for your own health care.
“I feel sick.”
Breakfast Smoothie (serves one): ½ cup crushed ice, ½ banana, gob of vanilla yogurt, 6 strawberries, 4 chunks pineapple, fill with lemonade,
Of course, I’m exaggerating here. But it’s no exaggeration to say that most of the people in the United States have government-funded health care. They might not want to acknowledge it because they pay premiums and think they are paying for their health care. But people with Medicare, Tri-care, congress, state governors, postal workers, government clerks, they all pay premiums, yet their health care is funded by the government.
Statistics are easy to come by but difficult to interpret and double counting is definitely a problem. But here are some references: US population, Medicare and Medicaid (and here), State Children’s Program, Tri-care, the VA system, (and here), prison population, uninsured, healthcare workers, government workers, public school employment, and federal benefits.
And remember when you look at the stats. Do not undercount. Your local harbormaster is a government employee but his wife and two kids are covered under his health plan (that you pay for), so count them, too. And don’t over count, either. Just because someone is employed by a government agency that offers insurance that does not mean they can afford the insurance premiums even when offered.